"A recent CT scan made me realize that the clinical trial extending my life effectively excludes all but the most privileged cancer patients.

"I used to weasel out of scans. Chalk it up to trepidation about radiation and possible kidney damage, along with paranoid suspicions that such scans don’t yield definitive pictures. My oncologist and I had agreed to fudge on frequent testing. But the clinical trial did not."

"A new study has found for the first time that the endocrine-disrupting chemical bisphenol A (BPA) reprograms the developing prostate, making the gland more susceptible to precancerous lesions and other diseases later in a man's life. The results will be reported Sunday at the joint meeting of the International Society of Endocrinology and the Endocrine Society: ICE/ENDO 2014 in Chicago.

" 'By using two novel models of human prostate development involving embryonic stem cells, this study is the first to show that low doses of BPA can actually reprogram human fetal prostate tissue in a manner that raises the risk of prostate diseases as men age,' said the study's presenting author, Esther Calderon-Gierszal, a PhD student at the University of Illinois at Chicago, Chicago, IL."

"In an online report in the journal Cancer, a team of University of Chicago cancer specialists have described the first tool—11 questions, assembled and refined from conversations with more than 150 patients with advanced cancer—to measure a patient’s risk for, and ability to tolerate, financial stress. The researchers refer to the expense, anxiety, and loss of confidence confronting cancer patients who face large, unpredictable costs, often compounded by decreased ability to work, as “financial toxicity,” and they have named their patient-reported outcome measure COST (COmprehensive Score for financial Toxicity)."

"Takeda Pharmaceutical Company Limited announced today that it has voluntarily decided to end the development program for orteronel (TAK-700) for prostate cancer. The decision follows the results of two Phase 3 clinical trials in metastatic, castration resistant prostate cancer (mCRPC). The studies found while orteronel plus prednisone could extend the time patients lived before their cancer progressed, it did not extend overall survival in these patients. After careful consideration of the data from these trials, the company has determined that the drug has not demonstrated a clinical profile sufficient to move forward in mCRPC, given the availability of other therapies."

Editor's note: Orteronel is a drug that showed some promise in for treating metastatic castration-resistant prostate cancer (mCRPC). However, the manufacturers of the drug found that it was not good enough compared to other treatments, and they have decided to stop developing it. We recently posted a news story in which orteronel showed mixed results as a treatment for mCRPC.

"It seems that the futuristic space age populated by robots is here, ushered in irrevocably by surgery-performing robots. With the FDA’s 2000 approval of Intuitive Surgical’s da Vinci Surgical System, the use of these systems has flourished, both for oncologic and non-oncologic use.

"Robot-assisted procedures are exactly what they sound like — surgeries assisted by robots, not performed by robots. Robotic surgery provides 'seven degrees of freedom' to surgeons, mimicking each gesture and facilitating easier learning. Robotic instrumentation also reportedly quells hand tremors, unlike laparoscopic instrumentation.

"More than 500 patients who suffer from severe chronic pain related to cancer can participate in one of the largest trials in cancer pain in 145 hospitals spread over 21 countries worldwide.

"Many cancer patients suffer from severe chronic pain related to their cancer. Unfortunately many of these patients are not satisfied with their current treatment options for the management of their pain due to the limitations of these treatments.[1] The German pharmaceutical company Grünenthal is investigating the efficacy and safety of the new analgesic cebranopadol for the treatment of severe chronic pain and peripheral neuropathic pain. Patients suffering from cancer-related severe pain are encouraged to check if they qualify to participate in a large cancer pain phase III trial, the so-called CORAL trial. The CORAL trial aims to show that the investigational drug cebranopadol can provide equally strong analgesia as a standard strong opioid in cancer patients while causing considerably fewer side effects. As the first trial of cebranopadol's phase III clinical program, referred to as the OCEANIC PROGRAM(R), Grünenthal will start the CORAL trial in 145 hospitals spread over 21 countries, including the United Kingdom. More than 500 patients are planned to complete this trial by 2016. More information about the CORAL trial and participating hospitals is available athttp://www.oceanic-program.com."

"A national survey of patients reveals that physicians don't always fully discuss the risks and benefits of cancer screening, reports a new study in American Journal of Preventive Medicine.

"The study examined data from more than 1100 people aged 50 and older who made decisions about whether to undergo screening for breast cancer, colorectal cancer, or prostate cancer in the previous 2 years. Participants were asked whether their physicians discussed the pros and cons of screening and of forgoing screening, and if they had been given a choice whether or not to be screened."

"Men whose prostate-specific antigen (PSA) level increases after radical prostatectomy or radiotherapy but who have no known metastases comprise the second-largest group of patients with prostate cancer. However, no standard of care exists for these patients, according to James Mohler, MD, Associate Director, Senior Vice President of Translational Research and Chair of the Department of Urology at Roswell Park Cancer Institute (RPCI).

"In a review article that was recently published in the prestigious American Cancer Society journal Cancer, Dr. Mohler shares his expert perspective on the future of androgen-deprivation therapy for men with persistently increasing PSA levels after failed local therapy. He explains that earlier and more complete androgen-deprivation therapy may cure many men with advanced prostate cancer."

Five patient advocacy groups for diseases including cancer and AIDS urged the U.S. to force Obamacare insurers to lower co-payments on costly drugs, saying some plans discriminate against people with serious illness.

"Representatives of the groups, which acknowledged receiving funding from pharmaceutical companies, spoke today at an event organized by the industry’s Washington-based lobbyists. That group released a study showing that 60 percent of mid-level plans on the new health exchanges placed multiple sclerosis and cancer drugs on tiers with the highest level of co-payments, in many cases requiring 30 percent of the price or more."

"A simple noninvasive blood test matched with state-of-the-art molecular imaging of individual cells could help oncologists understand their patients' chances of survival, say researchers. Metastasis accounts for an estimated 90 percent of cancer deaths. For decades, researchers tried to develop a way to gauge a cancer's risk of metastasizing from a blood sample -- the long-sought-after liquid biopsy."

"A phase I trial that combined the investigational therapy cabozantinib with the already approved abiraterone acetate in metastatic castration-resistant prostate cancer (CRPC) patients shows that the two agents are tolerable, with the potential for improved efficacy.

"Christopher Sweeney, MBBS, medical oncologist at Dana-Farber Cancer Institute in Boston, presented the results (abstract #5027) at the American Society of Clinical Oncology Annual Meeting, held May 30–June 3 in Chicago."

Editor's note: A clinical trial to test a new treatment on volunteer patients found that a combination of the drugs cabozantinib and abiraterone acetate may be beneficial for treating metastatic castration-resistant prostate cancer (CRPC), but further testing is needed.

"Results of a new study on mice and a phase 1 trial of humans suggest that prolonged cycles of fasting - for 2-4 days at a time - not only protect against toxic effects of chemotherapy, but also trigger stem cell regeneration of new immune cells and clearing out of old, damaged cells.

"The study, by researchers from the University of Southern California (USC) in Los Angeles, and published in the journalCell Stem Cell, is the first to show that a natural intervention can trigger regeneration of an organ or system through stem cells.

"The team believes the findings could benefit people with immune system damage, for example if they have received chemotherapy treatment for cancer. It could also benefit the elderly whose immune systems are weakened through aging, making them more susceptible to disease."

Intuitively this week, my body felt like it needed to fast. Intuitively, even thought I'd only planned a two day juice fast, it turned into four. With the right plan for fasting, and doctor's supervision as needed depending on your state of health or knowledge about how to fast correctly, it is highly doable.

I use a company that specializes in juicing and provides a whole kit of raw juices designed to give me different nutrients at different times of the day and it's all organic. I was never hungry and only had one afternoon dealing with a detox headache from going off caffeine. The rest of the time I was completely energized. Returning to food now, my body is craving raw vegetables and has no desire for caffeine or some of the other nutritional "slips" into foods that aren't healthy for me.

Amazing to see more natural paths to healing being embraced by the medical community. Medical interventions are sometimes very necessary and so I am grateful that we have them. It's not an either/or...it's an and - how can more "traditional" medical approaches and some natural approaches work together for best outcomes...that's an exciting place to be.

"Lung, liver, and other visceral metastases are associated with the poorest survival in advanced hormone-refractory prostate cancer, according to results from a meta-analysis that sets the benchmark for prognosis.

"Liver metastases were even worse, with 40% higher adjusted odds of death compared with lung metastases after adjustment for performance status, prostate specific antigen (PSA), and age (median 12 months, P<0.001), the group reported here at the American Society of Clinical Oncology meeting."

"The FDA has issued an alert to health care professionals that docetaxel contains ethanol, which may cause patients to experience intoxication during and after treatment.

"The FDA is currently revising the labels of all docetaxel drug products to warn about this potential risk. Health care professionals should consider the alcohol content of docetaxel when prescribing or administering the drug to patients, especially in those whom alcohol intake should be avoided or reduced and when using it concomitantly with other medications."

"The open market cost of a radical prostatectomy (RP) varies widely in U.S. hospitals, according to research published in the March issue of Urology.

"Scott C. Pate, M.D., of the University of Iowa in Iowa City, and colleagues conducted a telephone survey of a cohort of 100 U.S. hospitals to solicit price information for RP. The authors used a caller profile of an uninsured 55-year-old man recently diagnosed with Gleason 3 + 4 prostatic adenocarcinoma."

"Low levels of vitamin D were associated with higher cancer mortality in people with a history of cancer, a study found.

"Based on a meta-analysis, low 25(OH) vitamin D levels were tied to a risk ratio of 1.70 (95% CI 1.00-2.88) in cancer patients with a disease history. Inadequate vitamin D levels also were linked to an increase in all-cause mortality (RR 1.57, 95% CI 1.36-1.81) and cardiovascular mortality (RR 1.41, 95% CI 1.18-1.68), reported Ben Schöttker, PhD, of the German Cancer Research Center in Heidelberg, and colleagues in BMJ."

"Specialists who treat prostate cancer agree that active surveillance is an effective option—yet most don't recommend it when appropriate for their own patients, according to a study in the July issue of Medical Care .

"Rather, urologists are more likely to recommend surgery and radiation oncologists are more likely to recommend radiation therapy—the treatments provided by their own specialties. 'Given the growing concerns about the overtreatment of prostate cancer, our study has important policy implications about possible barriers to promoting active surveillance and specialty biases about optimal treatment regarding localized prostate cancer,' comments Dr Simon P. Kim of Yale School of Medicine."

"A new prostate cancer survey revealed that only 41 percent of men with prostate cancer were referred to an oncologist at some point during their prostate cancer journey. The survey, released by ZERO – The End of Prostate Cancer, is the organization's first patient education survey, with the goal of better understanding the experiences of those affected by prostate cancer and learning about their educational needs."

"A new Moffitt Cancer Center study published Thursday in Genetics in Medicine shows that counseling from a genetic health care provider before genetic testing educates patients and may help reduce unnecessary procedures.

"Up to 10 percent of cancers are inherited, meaning a person was born with an abnormal gene that increases their risk for cancer. "Pre-test genetic counseling in which a health care provider takes a thorough family history and discusses the potential risks and benefits of genetic testing is standard of care as recommended by the American Society of Clinical Oncology and National Society of Genetic Counselors," said Tuya Pal, M.D., a board-certified geneticist at Moffitt and senior author of the paper."

"Scientists at the University of Wisconsin Carbone Cancer Center (UWCCC) report that a new class of tumor-targeting agents can seek out and find dozens of solid tumors, even illuminating brain cancer stem cells that resist current treatments.

"What's more, years of animal studies and early human clinical trials show that this tumor-targeting, alkylphosphocholine (APC) molecule can deliver two types of 'payloads' directly to cancer cells: a radioactive or fluorescent imaging label, or a radioactive medicine that binds and kills cancer cells.

"The results are reported in today's issue of the journal Science Translational Medicine, and featured in the journal's cover illustration and podcast."

Editor's note: This story discusses a new method to make cancer cells visible to oncologists, and to deliver drugs directly to cells. The method uses a molecule called APC, which makes a beeline for cancer cells and can deliver imaging labels or radiotherapy treatments.

"Experimental drugs being tested in clinical trials for leukaemia may also boost the body’s immune response against other forms of cancer, according to research from University College London (UCL).

"The drugs target an important protein called p110δ, produced in large amounts in white blood cells called ‘leukocytes’.

"Leukaemias can develop if leukocytes become cancerous, making p110δ a promising target for treating this form of cancer.

"And recent clinical trials using these drugs have shown encouraging results. But until now the potential benefit of these drugs for other types of cancer had remained unexplored.

"In the latest study, published in Nature, researchers working with mice bearing solid tumours found that the drugs - called p110δ inhibitors - helped boost their immune response against a range of tumour types – including breast cancer."

Editor's note: Scientists have tested new drugs in mice with a variety of tumor types, including breast cancer, and found that the drugs may help the mice fight off cancer. These drugs are already being used in humans in clinical trials for leukemia, so it might not be long before scientists try the drugs in volunteer patients with other types of cancer.

"Primary care physicians have responsibility for promoting a healthy lifestyle, ensuring appropriate follow-up for cancer recurrence, and assessing and monitoring the long-term physical and psychological effects of prostate cancer, according to a report in CA: A Journal for Cancer Clinicians.

" 'More cancer patients are living longer, and it's really taking more time and more effort for oncology providers to care for them,' guideline co-author Rebecca L. Cowens-Alvarado, MPH, of the American Cancer Society, told MedPage Today. 'The burden on oncology care providers is really great.' "

"Karyopharm Therapeutics Inc., a clinical-stage pharmaceutical company focused on the discovery and development of novel first-in-class drugs directed against nuclear transport targets for the treatment of cancer and other major diseases, today announced the initiation of a Phase 2 trial of its novel, oral Selective Inhibitor of Nuclear Export (SINE) compound Selinexor (KPT-330) in patients with metastatic hormone-refractory prostate cancer (HRPC). The study, referred to as the SHIP (Selinexor in Hormone Refractory Indications in Prostate Cancer) study, is led by Drs. Christopher J. Logothetis and John Araujo of the M.D. Anderson Cancer Center at the University of Texas in Houston and is being funded in part by a grant from the Prostate Cancer Foundation."

Editor's note: This story describes a new clinical trial to test a prostate cancer treatment in volunteer patients. The new drug is called Selinexor (aka KPT-330), and it may benefit patients who have been diagnosed with metastatic hormone-refractory prostate cancer.

"Anti-androgen hormonal therapy, also called chemical castration, can be an important defense against further disease progression for patients with prostate cancer that has traveled and grown in other areas, or metastasized—but some cases simply do not respond to this treatment. A groundbreaking molecular imaging agent has been developed to help clinicians find as much cancer as possible, whether it is responding favorably or not, in an effort to improve clinical decision making for these patients, say researchers at the Society of Nuclear Medicine and Molecular Imaging's 2014 Annual Meeting."

"At the end of yoga sessions for cancer patients, we are told to say to ourselves, 'I am whole, healed and healthy in this and every moment.' Perversely, since in yoga we express aspirations as if they were already so, the sentence reminds me of people who congratulate me on being 'cancer free.' Stable disease often goes unrecognized.

"Perhaps the concept of chronic cancer has been hard to comprehend because public discussion tends to focus on the initial diagnosis of breast cancer. Early detection of breast cancer yields good survival rates and many patients can consider themselves cured. Often we assume a clear-cut partition between survivors and the terminally ill."

Editor's note: This article addresses the under-recognition of chronic cancer that is neither cured nor quickly progressing, and how patients cope with finding themselves in this "gray area."

Finally! Credit to the advocates for finally creating recognition for a segment of the cancer survivor population that has long been kept out of conversations - and, yes, even some support groups. Education is the first step. Chronic and metastatic disease can be a confronting conversation but to ignore the unique challenges, concerns and needs of any part of the population dealing with the impact of cancer is not acceptable. Wonderful to see a mainstream media source bringing this issue to the forefront. Education leads to less fear, less judgment, less ignorance and greater compassion, connection and support.

This article raises an important facet of some cancers -- that of a chronic condition rather than either a "cure" or an actively progressing disease. How others view this "gray area" vs. how cancer patients view it can make a difference in how supported the individual feels. Nonetheless, my view is that the cancer patient's perspective, attitudes and beliefs trump what goes on externally, and that we can choose happiness regardless of what is going on around us.

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